Objectives: The current study aimed to determine the Spontaneous Bacterial Peritonitis (SBP) risk due to increased use of Proton Pump Inhibitors (PPIs) among cirrhotic patients with ascites. Methods: This retrospective case-control study was conducted at Chandka Medical College & Hospital, Larkana from March 2013 to February 2014, involving 215 cirrhotic patients with ascites. Paracentesis was performed to distinguish cirrhotic patients with SBP and Polymorphonuclear Neutrophil (PMN) count ≥ 250 neutrophils/mm3 (cases) and non-SBP with PMN count < 250 neutrophils/mm3 (controls). The demographic details, history of PPIs use before admission and duration of Chronic Liver Disease (CLD) were inquired and statistical analysis was carried through SPSS Version 23.0. Results: Increased pre-hospital PPI intake was observed among cirrhotic patients with SBP (69.8%) as compared to those without SBP (48.8%; p = 0.014). The mean duration of PPI use was 19.16 ± 4.772 days, and it was more significant among older cirrhotic patients (p < 0.05). Increased duration of CLD was observed among PPI users, i.e. 20.47 ± 6.305 months vs. 18.95 ± 5.527 months among non-PPI users (p < 0.05). Conclusions: Our results show that cirrhotic patients with ascites consuming PPIs are more likely to develop SBP as compared to non-PPI users. doi: https://doi.org/10.12669/pjms.37.4.3476 How to cite this:Shaikh BA, Shaikh ZA, Shah AH, Kumar A. Determining the Risk of Spontaneous Bacterial Peritonitis due to increase use of Proton Pump Inhibitors among cirrhotic patients with ascites. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.3476 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Chronic kidney disease (CKD) is a world public health problem that is related with high morbidity and mortality. CKD patients can present with different skin manifestations, often benign with much impact on quality of patients life. Study Design: Case-series study. Setting: Nephrology Unit Civil Hospital Larkana. Period: From 1st January 2018 to 30th June 2018. Material and methods: 141 patients of ESRD on regular HD for at least 1 month. Patients were chosen randomly for evaluation of cutaneous changes regardless of their gender, age, sex and etiology of ESRD. General and dermatological examination of the skin, hair, nails, and oral mucosa was performed by consultant dermatologist. Data were analyzed by using IBM SPSS version 23.0. Descriptive analyses performed using mean with standard deviation and median with inter quartile ranges of quantitative data set. Count and percentages were reported for categorical data set. Results: In the present study there were one hundred and forty one patients. Out of them skin manifestations of patients, 87.9% had Xerosis, 31.9% found with skin hyper pigmentation, 9.2% had Subungal Hyperkeratosis, 24.1% had Uremic Pruirtis, 45.4% had Pallor, and 6.4% found with Bruises. There were 9.9% cases of Alopecia, 17.7% cases of half n half nail, 1.4% cases of half n half nail with alopecia, 9.2% cases of Koilionychia, 0.7% cases of Koilionychia with alopecia, 2.8% found with koilonychias and half n half nail, 2.1% with leuconycia and koilionychia, 15.5% with Leuconychia, 2.1% found with Leuconychia and alopecia, and 0.7% found with Leuconychia, koilonychia & alopecia in Hair and Nail changes. Conclusion: The range of skin manifestations vary in different studies. Although often benign with much impact on quality of patient’s life and life can be threatening. Early treatment of skin disorders can improve the quality of life.
Aim: To determine the frequency of nonalcoholic steatohepatitis in patients with liver cirrhosis. Study Design: Retrospective/observational Place and Duration of Study: Department of Medicine, Chandka Medical College Hospital, Larkana from 1st July 2020 to 31st March 2021. Methodology: One hundred and twenty patients of both genders presented with liver cirrhosis were enrolled in this study. Patient’s detailed demographics including age, sex, body mass index, smoking status, alcohol consumption and family history of liver disease were recorded after taking written informed consent. Laboratory examination was done to examine the proportion of hepatitis B virus, hepatitis C virus and nonalcoholic steatohepatitis. Results: There were 68 (56.67%) males and 52 (43.33%) were females with mean age 45.74±10.54 years. Among all the patients hepatitis C virus was found in 62 (51.67%) patients, 15 (12.5%) had hepatitis B virus, 17 (14.17%) had hepatitis B virus + hepatitis C virus and nonalcoholic steatohepatitis was found in 26 (21.67%) patients. Conclusion: Nonalcoholic steatohepatitis was the major cause of liver cirrhosis in Pakistani population. The proportion of NASH in liver cirrhosis patients was 21.67%. Keywords: Nonalcoholic steatohepatitis (NASH), Liver Cirrhosis, Hepatitis B virus, Hepatitis C virus
Aim: To determine knowledge of hypoglycaemic symptoms & their self-management among pts with type II diabetes mellitus. Study Design: Descriptive, cross-sectional. Place and duration of study: OPD Clinic of Department of Medicine, Chandka Medical College Hospital Larkana from 23rd May 2019 to 22nd November 2019. Methodology: One hundred and thirty five patients with type II diabetes mellitus of age 35- 60 years were selected. Patients with type I DM and neuro-psychiatric illness were excluded. The symptoms of hypoglycemia and their responses to those symptoms were recorded. Results: The mean age of 47.07±6.04years and majority of the patients 83 (61.48%) were between 46-60 years of age. Seventy two (53.33%) were male and 63 (46.67%) were females. Mean duration of diabetes mellitus was 6.90±3.86 years. Adequate knowledge of hypoglycemic symptoms and their self-management among patients with type II diabetes mellitus was found in 62 (56.9%) patients. Conclusion: Hypoglycemic patients are significantly unaware of their condition and have a very low knowledge about hypoglycemia and its self-management. Keywords: Type II diabetes, Hypoglycemic symptoms, Knowledge
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